Brief introduction of nutritional therapy for patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease, called COPD in Chinese, is a preventable and treatable disease with limited airflow. Airflow restriction is not completely reversible, but gradually develops, which is related to the abnormal inflammatory response of the lungs to harmful gases or particles (such as cigarette smoke). COPD mainly involves the lungs, but it can also cause systemic (or extrapulmonary) adverse reactions.

heat quantity

Heat supply can be calculated according to the formula: daily heat demand =H-B estimated value× c×1./kloc-0 /× activity coefficient.

The estimated value of H-B is calculated by formula. Required by men: daily energy requirement (kj/d) = (66.47+5.0× height (cm))+ 13.75× weight (kg)-6.76× age (year) ]×4. 184.

Female needs: daily energy requirement (kj/d) = (655.1+1.85× height (cm)) +9.56× weight (kg)-4.68× age (year) ]×4. 184.

Where c is the correction coefficient, which is 1. 16 for males and 1. 19 for females. 1. 1 In order to correct the weight loss of patients, 10% BEE should be increased. 1.3 is the mild activity coefficient, and if in bed,1.2; The moderate activity coefficient is1.5; The violent activity is 1.75.

Energy is the foundation of life. We can estimate the basic energy consumption (BEE) according to the patient's gender, age, height and weight, and then calculate its added value according to the patient's disease state and activity, so as to calculate its demand.

Patients with chronic obstructive pulmonary disease are in a state of hypermetabolism on protein, but not in a state of hyperdecomposition. Weight loss is more due to fat decomposition, which has no obvious effect on lean tissue. Therefore, adapting to the intake of protein can alleviate the burden balance, but excessive intake of protein will aggravate hypoxemia and hypercapnia, and increase the ventilation and oxygen consumption per minute. In addition, protein consumes more water than sugar and fat when producing heat. Excessive intake of protein will lead to increased urinary calcium, resulting in increased calcium demand and fluid imbalance, so it is enough to give 1~ 1.5g/kg standard weight every day.

Fat has a lower respiratory quotient, which can reduce the production of carbon dioxide, which is beneficial to COPD patients, especially those with hypercapnia and limited ventilation. Therefore, the proportion of fat in function can be increased. However, attention should be paid to adjusting the fatty acid structure in high-fat diet to prevent hyperlipidemia or damage to reticular epithelial system. Saturated fatty acids are beneficial to protect the integrity of reticular epithelial system and help isolate bacteria, but too much fatty acids can also damage liver function and easily lead to atherosclerosis.

Vitamins and Trace Elements Patients with chronic obstructive pulmonary disease often lack various vitamins, trace elements and minerals, so that oxygen free radicals can damage the body or affect the energy metabolism of various substances, further aggravating respiratory myasthenia. Therefore, attention should be paid to the energy metabolism of various substances in the diet treatment of COPD to further aggravate respiratory myasthenia. Therefore, it is necessary to treat COPD in diet.

Pay attention to supplement various trace elements and vitamins, especially vitamin C, vitamin E, phosphorus, calcium and potassium, to meet RDA standards.

Water often has body fluids in acute phase or accompanied by infection, so attention should be paid to controlling intake to prevent pulmonary edema from aggravating. Patients with pulmonary hypertension, cor pulmonale and heart failure should be strictly controlled to prevent further aggravation of cardiopulmonary burden and adverse reactions such as myocardial pump failure and gastrointestinal congestion.

When dehydration occurs during severe infection or a large amount of fluid is lost due to ventilator support, the fluid supply should be increased to correct dehydration.

Ways of nutritional supplement: For COPD patients in remission, gastrointestinal nutrition therapy can be used. Oral nutritional supplement is mainly based on normal physiological mechanisms: ① Oral administration can promote the secretion of digestive glands in gastrointestinal tract and help to absorb nutrients; ② It can directly provide nutrients needed by intestinal mucosa and maintain its function; ③ Severe COPD patients can be reduced.

At the same time, eat more fresh vegetables and fruits and supplement enough vitamins and trace elements necessary for human body. Vitamin C and carotene in fresh fruits and vegetables have protective effects on the lungs. Taking 100 mg vitamin C and 5000 IU vitamin A every day can enhance the defense ability of bronchial mucosa epithelium, maintain normal bronchial mucus secretion and ciliary activity, improve the symptoms of respiratory tract infection, promote the repair of bronchial mucosa and increase lung ventilation.

Patients should avoid eating too cold, too hot, spicy and blunt food, because it will stimulate the trachea and cause paroxysmal cough. Theophylline drugs can easily cause gastrointestinal side effects and can be taken after meals. Care should be taken to avoid excessive drinking of coffee, tea and Coca-Cola.

For patients with chronic obstructive pulmonary disease, a reasonable diet structure is the key to nutritional supplement. Because chronic diseases of respiratory system often recur when the weather turns cold in late autumn, when autumn and winter come, proper tonic can enhance the body's resistance. Chinese medicine believes that eating some honey, walnuts, dairy products, lilies, tremella, radishes, autumn pears, bananas, lotus roots and so on. Can help moisten the lungs; Edible ginseng, astragalus, yam, jujube, lotus seed, lily, licorice and other medicines and foods are homologous, and have the effect of strengthening the spleen and benefiting the lung.